What is a Stillbirth?
Stillbirth is a common term used to describe the death of a fetus in the uterus or during labor/delivery. In the Philippines, there are an estimated 16 stillbirth for every 1000 births annually. While there is some dispute over the legal definition and the time frame that the terminology refers to, a baby is usually considered stillborn after the 28th week of gestation. Prior to that, a woman is regarded to have had a miscarriage.
Why stillbirths occur
There are several causes of stillbirth, the most common of which are the following:
- Bleeding from placenta
- Fetal chromosome, genetic or metabolic abnormalities
- Fetal structural abnormalities
- Heart rhythm abnormalities
- Umbilical cord accidents
- Fetal hypoxia
- Pre-existing maternal medical conditions
- Maternal diabetes
- Maternal consumption of nicotine, alcohol and/or recreational drugs
Delivering a stillborn baby
Usually an in-utero death of a fetus does not pose any immediate health dangers to the mother. If left alone the mother will usually go into labor in two weeks time. However, most mothers choose to induce labor immediately. This is done with the help of vaginal pessaries (removable device placed into the vagina) that soften the cervix to induce the process. Sometimes, an intravenous (IV) drip may be given to start the uterine contractions while painkillers administered to ease the labor pains.
After the stillborn baby is delivered, part of the placenta may be retained within the uterus. The patient may therefore need a dilation and curettage procedure (D&C) under anesthesia to remove the placenta completely.
Once the delivery is completed, the parents are given a choice by the medical staff if they would like a post-mortem examination done on their stillborn baby. A post-mortem examination can provide useful information about the internal organs, including abnormalities that could have led to the stillbirth. The post-mortem is not mandatory.
After a day or two in hospital, the mother should be ready for discharge. Most women return within 6 weeks for a follow up check-up and to review post-mortem results, if any. If the patient was in advanced stage of pregnancy, some additional medication to suppress breast milk production might be needed.
Supporting someone who has had a stillbirth
Going through a stillbirth is an extremely traumatic experience for any family. Feeling intense emotions such as sadness, disbelief, denial, confusion, anger, and bitterness is natural and part of the grieving process.
When trying to help a woman who has lost a baby, the rule of thumb is just good manners: don’t offer your personal opinion of her life, her loss, or her prospects for children.
Before talking about the baby, it is imperative you ask if the parents are ready to talk about their loss. If they are not ready, then be there when they are, and just let them know you’re always there to listen. Anything that validates what the family is experiencing is acceptable. Avoid phrases like “it was meant to be”, “you’re young, you can have another” or, “your baby is in a better place.” No woman is looking to poll her acquaintances for their opinions on why it happened or how she should cope.
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